HB 71-ADVANCE HEALTH CARE DIRECTIVES REGISTRY 3:06:07 PM CO-CHAIR KELLER announced that the first order of business would be HOUSE BILL NO. 71, "An Act relating to a registry for advance health care directives." 3:06:35 PM REPRESENTATIVE SEATON moved to adopt the proposed Committee Substitute (CS) for HB 71, Version 26-LS0289\P, Bannister, 4/8/09, as the working document. 3:06:48 PM CO-CHAIR KELLER objected for the purpose of discussion. 3:07:00 PM REPRESENTATIVE HOLMES said HB 71 would create a way to access living wills on line. The changes that would be made through Version P are: Two sections of the bill, which would allow access to records by outside agencies, would be removed; the registry would consist only of names and scanned copies of the directives, thus creating less work for the department; only the individual whose living will is in the database would be allowed to ask to have that registry removed; the department would be left to regulate how the registry would be purged of deceased individuals; and the department would be exempted from liability in the operation and maintenance of the registry. She noted that there would be upcoming amendments addressing the issue of purging the registry. 3:08:35 PM REPRESENTATIVE HOLMES, in response to a question from Co-Chair Keller, stated that the individual who has asked to have his/her living will put into the registry would not be given on line access, but would be able to request a copy at any time from the department. The on line access would be limited to hospitals and other health care facilities. Representative Holmes added that the guardian or surrogate would also have access upon request. 3:09:15 PM BEVERLY WOOLEY, Director, Central Office, Division of Public Health, Department of Health and Social Services (DHSS), testified in support of the intent of HB 71 to provide health directives in a more efficient manner across the state. Initially, she related, the division anticipated that the date system required would be much more robust; however, the sponsor has amended the bill to the point that the system would be simplified. Ms. Wooley offered examples of how the department would scan the document brought in and provide that information to hospitals and health care providers as needed. That process will be worked out through regulations and care will be taken not to be in violation of HIPPA or any other requirements. MS. WOOLEY said the fiscal note will be scaled back. One of the changes that will be made within the department would be to house the responsibility for this process within the area of Healthcare Services versus Public Health. The shift would not impact the bill, she noted. Ms. Wooley relayed that the administration's position on the proposed legislation is neutral. 3:11:36 PM REPRESENTATIVE CISSNA shared that she has been in the position of losing a living will when her husband died, and she said "this" could have helped. She spoke of the process of changing a living will and questioned if there might be an easier way to do so. 3:12:25 PM MS. WOOLEY answered that the goal will be to have the most accurate information available in the timeliest manner possible. The department has been inquiring of other states to learn from their mistakes. 3:13:10 PM REPRESENTATIVE SEATON asked if other forms would be accepted by the department. 3:13:39 PM MS. WOOLEY responded that the department will not be able to take in forms indiscriminately, because it will have to follow the Health Insurance Portability and Accountability Act (HIPAA) requirements. The department will have to ensure that the form that is provided provides the department with the necessary release of that information in a legally sound manner. The forms must be either generated or approved by the department, she said. 3:14:19 PM REPRESENTATIVE SEATON asked if the department's form would take precedent over any form filed at a later date. 3:15:39 PM MS. WOOLEY replied that she is not sure, but that the final date would be the one that must be adhered to. The department's intent would be to ensure that the person's wishes "at that time" are the wishes that would be carried out. The department would work with its legal department to ensure that situations are clearly outlined. 3:16:33 PM CO-CHAIR KELLER expressed his wish that the process through the department would be as timely. 3:17:39 PM MS. WOOLEY concurred. 3:18:15 PM MARIE DARLIN, Coordinator, AARP Capital City Task Force, testified in support of HB 71. She characterized the proposed legislation as the next step in improving "what we've already done with the advance directives." 3:19:41 PM CO-CHAIR KELLER removed his objection. There being no further objection, Version P was before the committee. 3:20:05 PM CO-CHAIR HERRON moved to adopt Amendment A, which read [original punctuation provided]: Page 2, line 29 & 30 After "registry": Delete "and return it to the individual who made the directive" Page 3, line 4 After "file" Delete ", return," The committee took an at-ease from 3:20 p.m. to 3:21 p.m. 3:21:25 PM CO-CHAIR KELLER objected for the purpose of discussion. 3:21:52 PM REPRESENTATIVE HOLMES explained that Amendment A was requested by DHSS, and that it would remove the burden on DHSS to store and return the physical hard copy of the directives. 3:22:27 PM CO-CHAIR KELLER removed his objection. 3:22:35 PM REPRESENTATIVE SEATON objected for the purpose of discussion. 3:22:58 PM REPRESENTATIVE HOLMES, in response to Representative Seaton, explained that the intent of the bill is that the person who gives the directive to the department would be the only one to rescind it, but that copies of that directive could be given out to that person or "agent, guardian, or surrogate of the individual who made the directive." 3:24:07 PM REPRESENTATIVE SEATON removed his objection. There being no further objection, Amendment A was adopted. CO-CHAIR HERRON moved to adopt Amendment B, which read [original punctuation provided]: Page 3, line 14 After "criteria": Insert "and procedures for the collection, storage, access, distribution, removal and disposal of directives from the registry" 3:24:25 PM CO-CHAIR KELLER objected for the purpose of discussion. REPRESENTATIVE HOLMES explained that Amendment B would add specifications that were requested by the department. 3:25:11 PM CO-CHAIR KELLER removed his objection. There being no further objection, Amendment B was adopted. 3:25:34 PM CO-CHAIR HERRON moved to report CSHB 71, Version 26-LS0289\P, Bannister, 4/8/09, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, CSHB 71 (HSS) was reported from the House Health and Social Services Standing Committee. The committee took an at-ease from 3:25 p.m. to 3:26 p.m.